KEANDRA MOORE MCINTOSH NPI 1124508577

NPI Information

  • NPI: 1124508577
  • Provider Name: KEANDRA MOORE MCINTOSH
  • Classification: Licensed Vocational Nurse - 164X00000X
  • Entity Type: Individual
  • Address: 120 N WALNUT ST
    JEFFERSON, TX
    ZIP 75657
  • Phone: (903) 665-6131

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NPI Details

Keandra Moore Mcintosh is a licensed vocational nurse in Jefferson, TX. The provider is a licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. Keandra Moore Mcintosh NPI is 1124508577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

120 N WALNUT ST
JEFFERSON, TX
ZIP 75657-934
Phone: (903) 665-6131

The enumeration date for this NPI number is 8/15/2018 and was last updated on 8/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164X00000XLicensed Vocational Nurse185367TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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